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Concordance between clinical and histopathological diagnoses of biopsied oral cavity lesions

Aim: The aim of this study was to compare the clinical and histopathological diagnoses of biopsied oral cavity lesions, to evaluate the diagnostic concordance

characteristics of these lesions and to reveal the demographic characteristics of lesions. Material and Method: In this retrospective study, the histopathological

reports of patients who underwent biopsy between February 2013 and May 2018 were examined and analyzed. Gender, age, location of the lesion, clinical

and final histopathological diagnoses were determined from patient records. The lesions were divided into three main categories according to their final

histopathological diagnosis: Group 1 (Developmental, inflammatory, reactive lesions of the jaws), Group 2 (Cystic lesions), and Group 3 (Tumors and tumor-like

lesions). Results: The records of 506 patients were examined in the study. Patients’ ages ranged from 8 to 80 years (mean: 37.1 ± 17.5). The distribution of

lesions by groups was as follows: Group 1: 105 (20.8%), Group 2: 333 (65.8%), and Group 3: 68 (13.4%).Two hundred and seventy-five of the patients were male

(54.3%) and 231 of them were female (45.7%). Two hundred and fifteen of the lesions were localized in the maxilla (42.5%) and 291 of them were localized in

the mandible (57.5%). The concordance rate of diagnoses was 87.4% as a result of the comparison of clinical and final histopathological diagnoses. Discussion:

The clinician’s knowledge about the lesion has a significant effect on the concordance between clinical and histopathological diagnoses. The correct and early

diagnosis of lesions will prevent unnecessary treatments and delayed surgical operations.

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Comparison of two different anesthetic methods on pain perception in prostate biopsy

Aim: In this study, we aimed to compare the efficiency of two different local anesthetic techniques in transrectal ultrasound (TRUS) guided prostate biopsy.

Material and Method: The medical records of 798 patients who underwent 12 core transrectal ultrasound guided prostate biopsy were evaluated retrospectively.

The patients were divided into 2 groups to receive two different kinds of anesthesia during the procedure as follows: Group 1, rectal application of 2%

lidocaine gel and Group 2 periprostatic nerve block. The perception of pain during the insertion of the probe and during the biopsy procedure was scored for

each group separately by using a visual analog scale (VAS). Results: The mean age, mean total PSA level and mean prostate volume of the patients in Group

1 were 67.67 ± 8.91 years, 12.57 ± 17.67 ng/ml and 51.41 ± 22.62 ml respectively. The mean age, mean total PSA level and mean prostate volume of the

patients in Group 2 were 64.64 ± 7.63 years, 13 ± 18.02 ng/ml and 53.44 ± 44.01 ml respectively. The mean VAS scores of Group 1 and Group 2 during probe

insertion were 4,87 ± 1,14 and 5,19 ± 1,16 respectively (p<0.001). The mean VAS scores during biopsy were 3,56 ± 1,43 for Group 1 and 2,5 ± 0,91 for Group

2. The difference between these scores was statistically significant (p<0.001). Discussion: Using of lidocaine gel for analgesia in TRUS-guided prostate biopsy

significantly decreases the perception of pain experienced during the probe insertion procedure. On the other hand, PPNB is more effective than the using of

lidocaine gel in pain control when the level of pain experienced during the biopsy is examined. Analgesia is substantially ensured by using PPNB, but analgesia

combined with topical anesthetic agents could provide a more comfortable biopsy procedure.

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The learning curve in minimally invasive cardiac surgery procedures: a single surgeon experience

Aim: With the development of technology and surgical techniques, minimally invasive surgical approaches are being preferred by surgeons in cardiac surgery.

Smaller incisions with these approaches provide a faster recovery and higher life quality in the early post-operative period. In this study, we report our experience

with minimally invasive approaches in cardiac surgery. Primary end-point of the study was technical success and secondary was early discharge from the

hospital. Material and Method: Eighteen patients that underwent open-heart surgery with minimally invasive approaches between 2016 and 2017 at Hisar

Intercontinental Hospital were enrolled in the study. The median age was 53 (18–84) years, four were female (22%). J- mini-sternotomy was performed in

four patients requiring aortic valve replacement, and in six patients CABG X1 with beating-heart. T-sternotomy in two CABG X2 procedures), in four patients

requiring mitral valve replacement (MVR) and in two patients requiring ASD repair with right anterolateral mini-thoracotomy incision (4 MVR, 2 ASD). Results:

The mean cross-clamp time was 57.75 min (approximately two times longer than conventional methods). All patients were extubated in ICU 4–6 h after the

surgery. Early mortality (within 30 days after the surgery) was observed in only one patient due to non- cardiac reasons. No complications were observed from

the surgical wound. Discussion: Minimally invasive surgery is gaining popularity, and patients prefer these procedures more often. Exposure of surgical field,

performing better cases from small incisions are associated with the surgeon’s learning curve. With the increasing experience, minimally invasive cardiac

surgery can be considered for selected patients and especially for patients with high risk of wound complications who are obese, have diabetes, osteoporosis

or small skin incision preferred for patients with aesthetic anxiety.

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